“You can see those concentric rings going out”: Emergency personnel’s experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire

Saunders, Elizabeth C.; Metcalf, Stephen A.; Walsh, Olivia; Moore, Sarah K.; Meier, Andrea; McLeman, Bethany; Auty, Samantha G.; Bessen, Sarah Y.; Marsch, Lisa A.

doi:10.1016/j.drugalcdep.2019.107555

Cited by 36 publications

(38 citation statements)

References 48 publications

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“…Previous qualitative studies of emergency personnel experience have largely reported on negative aspects of overdose response. Indeed, participants in our study identified similar challenges, notably encountering repeat patients and patients who refuse transport [15,26]. Similarly, the core category we identified reflects previous findings of helplessness as a central, negative emotion during overdose response.…”

Section: Discussionsupporting

confidence: 75%

“…The purpose of this study was to explore the ways in which paramedics working within an urban center experience overdose response. Whereas similar qualitative studies to date have included paramedics within a larger pool of emergency personnel [15,26], this study brings a singular focus onto the perspectives of paramedics specifically. Furthermore, this study details experiences from a region with markedly high overdose rates relative to both Canadian and North American averages [2,13,27].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have examined healthcare worker experiences when treating overdose, however there has yet to be a focused exploration of paramedic perspectives on this topic [26]. As the primary providers of pre-hospital medical care, paramedics are uniquely situated amongst other emergency personnel.…”

Section: Introductionmentioning

confidence: 99%

“…As the primary providers of pre-hospital medical care, paramedics are uniquely situated amongst other emergency personnel. Differences have been noted between paramedics, fire fighters, and law enforcement officers regarding attitudes towards overdose response, and this has led to a call for occupation-specific investigations [15,26]. Understanding the unique challenges and concerns of paramedics can inform the types of support provided to these frontline workers amidst an ongoing public health emergency.…”

Section: Introductionmentioning

confidence: 99%

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‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

et al. 2020

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Background Overdose response has become an increasingly relevant component of paramedic practice, particularly in light of increased opioid overdose globally. Previous studies have noted gaps in our understanding regarding the unique challenges which paramedics face during this form of pre-hospital emergency care. The aim of this study is to explore and describe the ways in which paramedics experience overdose response, specifically within a community markedly affected by the overdose crisis. Methods Ten participants were recruited from a single ambulance station located in an urban center in Western Canada. Two rounds of semi-structured individual interviews were conducted, and data saturation was found to have been reached. Verbatim transcripts were produced and subject to two rounds of descriptive and pattern coding. A second researcher reviewed all of the codes, with disagreements being handled by discussion until agreement was obtained. Themes were identified, along with a Core Category which seeks to describe the underlying dynamics of overdose response represented in our data. The concept of a Core Category was borrowed from Grounded Theory methodology.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

et al. 2020

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“…One significant barrier is that people who use drugs are often hesitant to call emergency services when an overdose occurs due to fear of police involvement [14,15]. First responders also report suffering emotional consequences due to increased numbers of overdose situations [16].…”

mentioning

confidence: 99%

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

et al. 2020

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Background: In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are wellpositioned to administer naloxone and prevent overdose death. Methods: We conducted key informant interviews with 18 individuals with past or current opioid and heroin drug use who had administered naloxone to a peer during an overdose emergency. Interviews explored individuals' experiences with administration and their recommendations for program and policy improvement. Data were systematically coded and analyzed for themes. Results: Participants sought naloxone rescue kits because they perceived high risk of overdose. They described high satisfaction with training and felt prepared to administer naloxone during overdose incidents. Overwhelmingly, participants perceived naloxone to be effective and emphasized the need to make it widely available. Findings suggest that engagement in overdose prevention strategies other than naloxone differs by gender, with females more likely than males to use multiple different strategies. Participants described that overdose experiences do not have a lasting impact on drug use behaviors. Conclusions: Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.

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Compassion, stigma, and professionalism among emergency personnel responding to the opioid crisis: An exploratory study in New Hampshire, USA

et al. 2022

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Objective Drug overdoses are the leading cause of death in the United States for those under 50 years of age, and New Hampshire has been disproportionately affected, resulting in increased encounters with the emergency response system. The ensuing impact on emergency personnel has received little attention. The present study aimed to explore the experiences and perspectives of emergency personnel responding to the opioid crisis in NH, with a focus on their views toward people who use opioids. Methods Thirty‐six emergency personnel (emergency department clinicians, n = 18; emergency medical service providers, n = 6; firefighters, n = 6; and police officers, n = 6) in 6 New Hampshire counties were interviewed about their experiences responding to overdoses and their perspectives on individuals who use opioids. Directed content analysis was used to identify themes in the transcribed, semistructured interviews. The results were reviewed for consensus. Results Several categories of themes were identified among emergency personnel's accounts of their overdose response experiences and perspectives, including varied degrees of compassion and stigma toward people who use opioids; associations between compassion or stigma and policy‐ and practice‐related themes, such as prehospital emergency care and the role of emergency departments (EDs); and primarily among personnel expressing compassion, a sense of professional responsibility that outweighed personal biases. Conclusions Despite the magnitude of the ongoing opioid crisis, some emergency personnel in New Hampshire have sustained or increased their compassion for people who use opioids. Others’ perspectives remain or have become increasingly stigmatizing. The associations of compassion and stigma with various policy‐ and practice‐related themes warrant further investigation.

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“You can see those concentric rings going out”: Emergency personnel’s experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire

Cited by 36 publications

References 48 publications

‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

Compassion, stigma, and professionalism among emergency personnel responding to the opioid crisis: An exploratory study in New Hampshire, USA

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